Treating tuberculous lymphadenitis--ifs and buts.

Treatment of tuberculous (TB) lymphadenitis is virtually a specialist's job due to multiple aetiopathological factors. Diagnosis is difficult often requiring biopsy for several times. Treatment monitoring is more complex due to peculiar behaviour of TB lymph nodes. Situation has become worse due to sharp increase in the incidence of atypical mycobacteria. Due to profound improvement in antibiotic action, life-expectancy of immuno-compromised patients has also increased along with increased incidence of atypical mycobacteria in them. Clarithromycin, ethambutol, rifabutin and amikacin seem to act best on atypical mycobacteria-induced lymphadenitis. Along with rise of multi-drug resistance (MDR), drug-resistant TB lymphadenitis cases are also on the rise.